Red flags & when to go in person for Hemorrhoids in Children

Audience: pediatric

Hemorrhoids are swollen veins around the anus or lower rectum that can cause discomfort in children. They often result from constipation, straining during bowel movements, or sitting for long periods. Many children with hemorrhoids experience itching, mild pain, or small amounts of bleeding during bowel movements. Usually, these symptoms can be managed at home with simple care such as increasing fiber and fluids. However, some signs mean a child should see a healthcare provider in person. These include heavy bleeding, severe pain, or changes in bowel habits. Telemedicine can help assess mild symptoms and guide home care, but it cannot replace a physical exam when serious symptoms occur. Knowing when to seek in-person care helps keep your child safe and comfortable.

Red flags — go in person / ER

• Heavy or continuous rectal bleeding — seek immediate in-person care.
• Severe anal pain or swelling with redness or pus — may indicate infection needing urgent evaluation.
• Fever or feeling very unwell along with hemorrhoid symptoms — requires prompt medical attention.

What telemedicine can do

• Assessment of mild symptoms like itching, minor pain, or small amounts of bleeding.
• Guidance on home care, diet, and hygiene to relieve symptoms.
• Determining if symptoms require in-person evaluation.

What telemedicine cannot do

• Severe pain or heavy bleeding requiring physical examination.
• Signs of infection such as redness, swelling, or pus around the anus.
• Persistent changes in bowel habits or systemic symptoms like fever.

What Are Hemorrhoids in Children?

Hemorrhoids are swollen blood vessels near the anus or lower part of the rectum. In children, they can happen when they strain too much during bowel movements or are constipated. Hemorrhoids may cause itching, mild pain, or small amounts of bright red blood on toilet paper. They are usually not serious and often get better with simple home care.

Common Symptoms to Watch For

Children with hemorrhoids may have:

These symptoms often improve with diet changes and good bathroom habits.

When to Seek In-Person Care

Some symptoms need prompt medical attention. Go to a healthcare provider in person if your child has:

These signs may mean a more serious problem that needs examination and treatment.

How Telemedicine Can Help

Telemedicine visits allow healthcare providers to:

Telemedicine is useful for mild symptoms but cannot replace physical exams when red flags appear.

Tips to Prevent Hemorrhoids in Children

To help prevent hemorrhoids:

These steps often reduce symptoms and prevent hemorrhoids from coming back.

How to prepare for your tele-visit

• Have a list of your child's symptoms ready, including when they started and how severe they are.
• Prepare to describe any bleeding, pain, or lumps noticed.
• Gather information about your child's diet, bowel habits, and any recent illnesses.
• Ensure a private, well-lit space for the video call if possible.
• Have a family member assist if your child is very young or unable to communicate clearly.

After your tele-visit

• Follow the healthcare provider's advice on diet, hydration, and hygiene.
• Use recommended over-the-counter treatments or medications as directed.
• Monitor your child's symptoms closely and note any changes.
• Schedule an in-person visit if symptoms worsen or red flags appear.
• Keep follow-up telemedicine appointments as advised for ongoing support.

FAQs

Can hemorrhoids in children go away on their own?

Yes, mild hemorrhoids often improve with simple home care like increasing fiber and fluids, and avoiding straining during bowel movements.

Is bleeding always a sign of something serious?

Small amounts of bright red blood on toilet paper can be common with hemorrhoids. However, heavy or continuous bleeding should be evaluated by a healthcare provider in person.

What can I do to help my child avoid hemorrhoids?

Encourage a high-fiber diet, plenty of fluids, regular bathroom habits, and avoid prolonged sitting on the toilet. Keeping the anal area clean and dry also helps.

When should I not rely on telemedicine for hemorrhoid symptoms?

If your child has severe pain, heavy bleeding, signs of infection, fever, or persistent changes in bowel habits, they should be seen in person promptly.

Are hemorrhoids common in children?

Hemorrhoids are less common in children than adults but can occur, especially if the child is constipated or strains during bowel movements.

Sources

1. Hemorrhoids - MedlinePlus — U.S. National Library of Medicine / National Institutes of Health.
2. Hemorrhoids - Mayo Clinic Patient Care & Health Information — Mayo Clinic.
3. Hemorrhoids - Merck Manuals Consumer Version — Merck & Co., Inc..
4. Constipation in Children: Clinical Report — American Academy of Pediatrics.
5. Telehealth: What You Need to Know — Centers for Disease Control and Prevention (CDC).

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child has any concerning symptoms or red flags, seek prompt evaluation by a healthcare professional in person.